If your epilepsy doesn’t respond to any anticonvulsant medications or treatments, perhaps you don’t have epilepsy after all. Researchers from the Manchester Heart Centre and the David Lewis Centre for Epilepsy in the United Kingdom believe many people diagnosed with treatment-resistant or atypical epilepsy may actually be suffering from a cardiovascular disorder.
The study included 88 participants, ages 16 to 75, who experienced recurrent seizure-like episodes that had been diagnosed as epilepsy. Each was given tests designed to diagnose recurrent fainting. During these tests, they were monitored with electroencephalogram (EEG), which traces the electrical activity of the brain. In addition, some participants had a small cardiac-monitoring device implanted under the skin that served as a continual electrocardiogram (ECG), which traces the electrical activity of the heart.
The cause of seizures in 43 of the 88 participants was not epilepsy at all. In 26 cases, a cardiovascular problem was found to be the cause. In the remaining 17, the attacks were found to have a psychological origin.
The use of the implantable cardiac monitor aided in the diagnosis by helping to differentiate between an epileptic seizure and a convulsive fainting episode. The former is caused by abnormal electrical activity in the brain and the latter by an interruption in normal blood flow to the brain. Diagnosing this condition can be very difficult because the interruption only shows up on a test if a person is actually experiencing an attack during the test. Using the implantable device allows monitoring to continue for over a year, increasing the chances that an attack will occur during monitoring.
If the cause of your seizures is determined to be due to a cardiovascular problem, treatment with the proper medication or insertion of a pacemaker may be able to eliminate your episodes. The anticonvulsant medications used for epilepsy are not effective in treating seizures due to cardiovascular problems.
Epilepsy is estimated to affect more than four million people in the United States and Europe. The researchers estimate that approximately one-third of them have been misdiagnosed.